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Diet, Physical Activity and Gestational Weight Gain Patterns among Pregnant Women Living with Obesity in the North East of England: The GLOWING Pilot Trial.

ABSTRACT: Maternal diet, physical activity (PA) behaviours, and gestational weight gain (GWG) are important for optimum health of women and their babies. This secondary analysis of the GLOWING pilot cluster trial explored these among women living with obesity in high deprivation. Pregnant women completed food frequency, PA and psychosocial questionnaires. Weights were retrieved from medical records and measured during routine appointments with midwives. Descriptive and regression analyses were stratified by obesity class. A total of 163 women were recruited; 54.0% had class 1 obesity, 25.8% class 2, 20.2% class 3, and 76.1% lived in the two most deprived quintiles. Women had suboptimal dietary intake, particularly for oily fish, fruit and vegetables. PA was predominantly light intensity, from household, care and occupational activities. Most women gained weight outside of Institute of Medicine (IOM) guideline recommendations (87.8%); women in class 3 obesity were most likely to have inadequate GWG below IOM recommendations (58.3%, p < 0.01) and reduced odds of excessive GWG compared with class 1 (AOR 0.13, 95% 0.04-0.45). Deprived women with obesity have a double inequality as both increase pregnancy risks. This population requires support to meet guideline recommendations for diet, PA and GWG. Further research exploring obesity classes would inform policies and care to achieve the best pregnancy outcomes.

SUBMITTER: Heslehurst N

PROVIDER: S-EPMC8227571 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundGestational weight gain (GWG) has important health implications for both the mother and offspring. Maternal diet during pregnancy may play an important role in achieving adequate GWG, although its precise role is unclear.ObjectivesAssociations between maternal dietary components (fruits and vegetables, added sugar, percentage energy from fat, dairy) and GWG were examined in 327 pregnant women from the Archive for Research on Child Health cohort.MethodsSelf-reported usual dietary intake was assessed with validated dietary screening tools at the first prenatal visit. GWG was obtained from the birth certificate and was categorized as inadequate, adequate, or excessive according to the Institute of Medicine recommendations. Associations between dietary components and GWG were assessed using multivariable regression models, stratified by maternal prepregnancy BMI category.ResultsOnly 31.5% of women had adequate GWG, with 24.8% gaining insufficient weight and 43.7% gaining excessively. Women who consumed more fruits and vegetables were suggestively less likely to have excessive GWG (OR: 0.86; 95% CI: 0.75, 1.00) in the minimally adjusted model, but the association became nonsignificant after adjusting for covariates (OR: 0.89; 95% CI: 0.77, 1.03). In stratified models, higher fruit and vegetable intake was linked to lower likelihood of excessive GWG among women with obesity (OR: 0.77; 95% CI: 0.60, 0.97), whereas higher added sugar intake was linked to a slight reduction in likelihood of excessive GWG (OR: 0.91; 95% CI: 0.84, 0.99) among women with a prepregnancy BMI in the normal range. Other dietary components were not significantly associated with GWG.ConclusionsThese results suggest that consuming fruits and vegetables during pregnancy may reduce risk of excessive GWG among women with obesity. With the rising prevalence of obesity among women of reproductive age, interventions to increase fruit and vegetable intake during pregnancy may have broad public health impact by improving maternal and child health outcomes.

Project description:BackgroundGestational weight gain (GWG) is a modifiable risk factor associated with adverse birth outcomes. Studies have shown that the provision of multiple micronutrient supplements to pregnant women reduces the risk of low birth weight. However, the effect of multiple micronutrient supplements on GWG has been understudied.ObjectivesWe examined the effect of daily supplementation of pregnant women with multivitamins on GWG in relation to the GWG recommendation by the Institute of Medicine (IOM).MethodsPregnant women with gestational age between 12 and 27 wk were randomly assigned to receive daily multivitamins or placebo until delivery. Weight was measured at enrollment and every follow-up visit. Percentage adequacy of GWG was calculated as actual GWG divided by the recommended GWG according to the IOM recommendation. Binary outcomes included severely inadequate (<70%), inadequate (<90%), and excessive GWG (≥125%). The analysis included 7573 women with singleton pregnancies. Multiple linear regression models were used to examine the association between multivitamin supplementation and percentage adequacy of GWG, and log-binomial models were used for binary outcomes.ResultsThe mean percentage adequacy of GWG was 96.7% in the multivitamin arm and 94.4% in the placebo arm, with a mean difference of 2.3% (95% CI: 0.3%, 4.2%; P = 0.022). Compared with women in the placebo arm, those who received multivitamins had a lower risk of severely inadequate GWG (RR: 0.90; 95% CI: 0.83, 0.97; P = 0.008) and inadequate GWG (RR: 0.95; 95% CI: 0.91, 0.99; P = 0.018). No significant difference was found in excessive GWG.ConclusionsMultivitamin supplementation increased GWG and reduced the risk of severely inadequate and inadequate GWG among pregnant women in Tanzania. Together with previously reported beneficial effects of the supplements on birth outcomes in low- and middle-income countries, our findings support scaling up the use of prenatal supplements that include multivitamins in addition to iron and folic acid.This trial was registered at clinicaltrials.gov as NCT00197548.

Dataset Information

Diet, Physical Activity and Gestational Weight Gain Patterns among Pregnant Women Living with Obesity in the North East of England: The GLOWING Pilot Trial.

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